ST. ROSE OF LIMA ATHLETIC ASSOCIATION
APPLICATION TO COACH FOR ______-_______ ACADEMIC SCHOOL YEAR
ADDRESS:_____________________________________________________________________________________
PHONE:HOME:________________________ CELL:_________________________ WORK:___________________
EMAIL ADDRESS:_____________________________________________________________________________
I, (WILL/WILL NOT) (CIRCLE ONE) HAVE CHILDREN ATTENDING ST. ROSE OF LIMA SCHOOL DURING THE _________ - ___________ ACADEMIC YEAR
LIST NAMES AND GRADE OF EACH CHILD BELOW FOR THE _________ - ___________ SCHOOL YEAR
____________________________________________________________________________________________
I AM INTERESTED IN APPLYING FOR A (HEAD) (ASSISTANT) COACH POSITION (PLEASE CIRCLE ONE OR BOTH ABOVE)
INTERESTED SPORTS (YOU MAY LIST UP TO 3 IN ORDER OF PREFERENCE.
1:__________________________________2: _________________________________ 3: ____________________________
IF ACCEPTED TO COACH I UNDERSTAND THE FOLLOWING ARE MINIMUM CERTIFICATIONS REQUIRED BY THE DIOCESE OF TRENTON. PLEASE NOTE BELOW ALL CERTIFICATIONS THAT YOU CURRENTLY HAVE. IF YOU ARE SELECTED TO COACH AND ARE NOT CERTIFIED IN ANY OF THE AREAS BELOW, YOU WILL BE REQUIRED TO COMPLETE ALL BY THE FIRST PRACTICE DATE. THE BOARD WILL: ASSIST IN CONDUCTING, IDENTIFYING WHERE CLASSES CAN BE TAKEN AND WILL PAY FOR YOUR CERTIFICATION UPON COMPLETION OF EACH
CERTIFICATION TYPE _________________________________________________________ YES/NO WHEN/WHERE
1-RUTGERS S.A.F.E.T.Y CLINIC_________________________________________________________________
2-FINGERPRINTING AND BACKGROUND CHECK________________________________________________
3-FIRST AID/CPR CERTIFICATE________________________________________________________________
4-VIRTUS TRAINING CERTIFICATE_____________________________________________________________
5-OTHER_______________________________________________________________________________________
PREVIOUS COACHING EXPERIENCE/SPORT/ORGANIZATION/POSITION:
_________________________________________________________________________________________________________________________________
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PHILOSOPHY OF COACHING:__________________________________________________________________